CHOLESTEROL   (LIPIDS)

[treatment]  [diet] [back to screening]

Cholesterol is one of a range of blood fats collectively known as lipids.

There are 4 main elements measured when checking lipid levels or "cholesterol":
1. Total cholesterol, which includes,

2. LDL (low density) or "bad" cholesterol, and

3. HDL (high density) or "good" cholesterol

4. Triglycerides.

In otherwise healthy people, the goal is to have a Total Cholesterol less than 5.5, an LDL of less than 4.5 and a HDL of 1 or more. Triglycerides should be less than 2.6.

People with established cardiovascular disease or diabetes have lower target levels.

Abnormal lipid levels may be caused by any combination of hereditary factors, diet, being overweight and certain co-existing illnesses.

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TREATMENT

New guidelines and PBS subsidy eligibility were introduced from 1st December 2006.

Patients with very high risk of vascular disease should commence medication at any (even quite low) cholesterol levels - as well as following strict dietary recommendations. 
These patients include those with:
- symptomatic coronary heart disease
- symptomatic cerebrovascular disease
- symptomatic peripheral vascular disease
- diabetes and microalbuminuria
- aboriginal and Torres Strait Islanders patients with diabetes
- diabetes aged 60 or more
- family history of coronary heart disease developing in 2 first degree relatives under 55 years of age
- family history of coronary heart disease developing in 1 first degree relative under 45 years of age

Having excluded other illnesses, all other people with abnormal lipids should have at least 6 weeks of strict diet modification to see whether that alone will correct the problem. 
The PBS subsidises "statin" medications when diet has failed and there is :

- Diabetes not included above : total cholesterol > 5.5
- Aboriginal and Torres Straight Islanders with hypertension : 
                    -total cholesterol > 6.5 or
                    -total cholesterol > 5.5 and HDL <1.0
-Patients with HDL < 1.0 :  total cholesterol > 6.5

- Patients with proven familial hyper-cholesterolaemia, family history of coronary artery disease symptomatic before 60 years in one or more first degree relative or family history of symptomatic coronary artery before 50 years in one or more second degree relatives :
        - aged 18 years or less when commencing treatment : LDL > 4.0
        - aged 19 or more years : LDL > 5.0  or
                                             total cholesterol > 6.5 or
                                             total cholesterol > 5.5 and HDL < 1.0
- Men 35 to 75 years, women post menopause to 75 years not included in above categories : total cholesterol > 7.5 or triglycerides > 4
- Other patients not included above : total cholesterol > 9 or triglycerides > 8

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DIET
Healthy eating is important for everyone.
In general, we should :

EAT LEAST : butter, margarine, ice cream, chocolate, cakes, chips and salt.

EAT MODERATELY : lean meat, fish (not battered), chicken, cheese, milk and eggs.

EAT MOST : vegetables, fruit, bread, cereals, rice, pasta, other grains, beans and nuts.

A CHOLESTEROL LOWERING DIET PLAN CAN BE DOWNLOADED BY CLICKING : DOWNLOAD